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Sodium Acetate

Medically reviewed by Last updated on Jul 8, 2020.


(SOW dee um AS e tate)

Dosage Forms

Excipient information presented when available (limited, particularly for generics); consult specific product labeling.

Solution, Intravenous, as anhydrous:

Generic: 2 mEq/mL (20 mL, 50 mL, 100 mL); 4 mEq/mL (50 mL)

Solution, Intravenous, as anhydrous [preservative free]:

Generic: 4 mEq/mL (100 mL)

Pharmacologic Category

  • Electrolyte Supplement, Parenteral

Use: Labeled Indications

Sodium source in large volume IV fluids to prevent or correct hyponatremia in patients with restricted intake; used to counter acidosis through conversion to bicarbonate


Hypernatremia and fluid retention

Dosing: Adult

Note: Sodium acetate is metabolized to bicarbonate on an equimolar basis outside the liver; administer in large volume IV fluids as a sodium source. Refer to Sodium Bicarbonate monograph.

Maintenance electrolyte requirements of sodium in parenteral nutrition solutions:

Acetate maintenance electrolyte requirement: IV: Acetate and chloride content should be adjusted to maintain acid-base balance with parenteral nutrition; use equal amounts of acetate and chloride and adjust ratio based on individual patient needs (Mirtallo 2004).

Sodium maintenance electrolyte requirement (combination of chloride and acetate, where applicable): IV: 1 to 2 mEq/kg/24 hours; customize amounts based on individual patient needs (Mirtallo 2004). General maximum sodium acetate: 100 to 150 mEq/24 hours.

Dosing: Geriatric

Refer to adult dosing.

Dosing: Pediatric

Note: Maintenance sodium should be incorporated into the patient's maintenance IV fluids; acid/base balance should be considered when selecting a sodium salt; acetate is converted to bicarbonate on an equimolar basis within the body and may affect serum pH.

Parenteral nutrition; maintenance sodium requirement: Note: A combination of salt forms may be necessary to fulfill sodium requirement (ASPEN [Mirtallo 2004]).

Infants and Children ≤50 kg: IV: 2 to 5 mEq/kg/day of sodium as an additive to parenteral nutrition solution.

Children >50 kg and Adolescents: IV: 1 to 2 mEq/kg/day of sodium as an additive to parenteral nutrition solution.

Metabolic acidosis: Limited data available: Infants, Children, and Adolescents: Each mEq of acetate is converted 1:1 to mEq of bicarbonate (HCO3-); dosage should be based on standard dosing formulas if blood gases and pH measurements are available. Refer to the Sodium Bicarbonate monograph for specific dosing details and equations.


IV: Must be diluted prior to IV administration; infuse hypertonic solutions (eg, >2.8% sodium acetate in sterile water [2.8% sodium acetate in sterile water has osmolarity approximately equivalent to 2% sodium chloride]) via a central line (Mortimer, 2006; Suarez, 2004). If diluted in D5W or other solution, the osmolarity may be higher requiring central line administration at a lower sodium acetate concentration.

Consult individual institutional policies and procedures.

Dietary Considerations

Sodium acetate anhydrous (2 mEq/mL): 1 mL = 164 mg sodium acetate anhydrous = 2 mEq of sodium (46 mg) and acetate (118 mg)


Store at room temperature of 20°C to 25°C (68°F to 77°F).

Drug Interactions

There are no known significant interactions.

Adverse Reactions

The following adverse drug reactions and incidences are derived from product labeling unless otherwise specified.

1% to 10%:

Cardiovascular: Localized phlebitis, thrombosis

Endocrine & metabolic: Electrolyte disturbance (dilution of serum electrolytes), hypernatremia, hypervolemia, hypocalcemia, hypokalemia, metabolic alkalosis, water intoxication

Gastrointestinal: Abdominal distention, flatulence

Respiratory: Pulmonary edema


Concerns related to adverse effects:

• Hypernatremia: Close monitoring of serum sodium concentrations is needed to avoid hypernatremia.

Disease-related concerns:

• Acid/base disorders: Use with caution in patients with acid/base alterations; contains acetate, monitor closely during acid/base correction.

• Edema: Use with caution in edematous patients.

• Heart failure (HF): Use extreme caution in patients with HF; monitor closely for edema.

• Hepatic impairment: Use with caution in patients with severe hepatic impairment.

• Renal impairment: Use with caution in patients with renal impairment; monitor serum sodium concentrations closely.

Dosage form specific issues:

• Aluminum: The parenteral product may contain aluminum; toxic aluminum concentrations may be seen with high doses, prolonged use, or renal dysfunction. Premature neonates are at higher risk due to immature renal function and aluminum intake from other parenteral sources. Parenteral aluminum exposure of >4 to 5 mcg/kg/day is associated with CNS and bone toxicity; tissue loading may occur at lower doses (Federal Register, 2002). See manufacturer’s labeling.

Other warnings/precautions:

• Extravasation: Avoid extravasation.

Monitoring Parameters

Serum electrolytes, including sodium, calcium, serum pH.

Pregnancy Risk Factor


Pregnancy Considerations

Animal reproduction studies have not been conducted. Sodium requirements do not change during pregnancy (IOM, 2004).

Patient Education

What is this drug used for?

• It is used to treat low sodium levels.

• It is used in the diet to meet sodium needs.

• It may be given to you for other reasons. Talk with the doctor.

WARNING/CAUTION: Even though it may be rare, some people may have very bad and sometimes deadly side effects when taking a drug. Tell your doctor or get medical help right away if you have any of the following signs or symptoms that may be related to a very bad side effect:

• Electrolyte problems like mood changes, confusion, muscle pain or weakness, abnormal heartbeat, seizures, lack of appetite, or severe nausea or vomiting

• Shortness of breath

• Excessive weight gain

• Swelling of arms or legs

• Signs of an allergic reaction, like rash; hives; itching; red, swollen, blistered, or peeling skin with or without fever; wheezing; tightness in the chest or throat; trouble breathing, swallowing, or talking; unusual hoarseness; or swelling of the mouth, face, lips, tongue, or throat.

Note: This is not a comprehensive list of all side effects. Talk to your doctor if you have questions.

Consumer Information Use and Disclaimer: This information should not be used to decide whether or not to take this medicine or any other medicine. Only the healthcare provider has the knowledge and training to decide which medicines are right for a specific patient. This information does not endorse any medicine as safe, effective, or approved for treating any patient or health condition. This is only a limited summary of general information about the medicine's uses from the patient education leaflet and is not intended to be comprehensive. This limited summary does NOT include all information available about the possible uses, directions, warnings, precautions, interactions, adverse effects, or risks that may apply to this medicine. This information is not intended to provide medical advice, diagnosis or treatment and does not replace information you receive from the healthcare provider. For a more detailed summary of information about the risks and benefits of using this medicine, please speak with your healthcare provider and review the entire patient education leaflet.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.